Provider Demographics
NPI:1689973562
Name:ROONI, TRISHA A (SLP)
Entity Type:Individual
Prefix:MRS
First Name:TRISHA
Middle Name:A
Last Name:ROONI
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61378 HEGSTROM RD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:WI
Mailing Address - Zip Code:54806-4237
Mailing Address - Country:US
Mailing Address - Phone:715-682-2092
Mailing Address - Fax:
Practice Address - Street 1:61378 HEGSTROM RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:WI
Practice Address - Zip Code:54806-4237
Practice Address - Country:US
Practice Address - Phone:715-682-2092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2709-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist